Alzheimer's Disease with Li-Xia

Case history

Li-Xia has been suffering from chronic tiredness, dejection
and forgetfulness. Some years ago, she already complained
that her memory had declined. Early 2006, her short term
memory became noticably worse. One day, I discovered that
she had totally no recollection of something I told her
the day before. I adviced her to have herself examined.
On Thursday, June 1, 2006, someone came to perform some
tests. Both Li-Xia and I were surprised by how bad she
performed on some simple memory tests. Also on the
Visual Association Test she did not score well.
Later, I discovered on the Internet that especially people
with Alzheimer's disease or suffering from a depression,
do not score well on this test. It took some time before
we received the results, and we were adviced to contact
the Neurology department of Medisch Spectrum Twente, a general hospital, in
Enschede. After the summer holidays we visited our GP.

On monday October 9, 2006, we went to see the neurologist
for the first time. While we were sitting in the waiting
room, I suddenly felt much older, because of all the old
people that were sitting in the waiting room, several of
them in a wheelchair. It felt a little unreal. The neurologist
performed some simple test and a general examination.
She decided some additional examinations: A psychological
examination and a MRI of her head.

On Thursday, October 19, 2006, Li-Xia underwent the psychological
examination during the morning. In the week that followed
the Neurologist contacted me, because she also wanted to
perform a lumbar puncture and have her cerebrospinal fluid
examined. The puncture was performed on Tuesday, November 7.
I went with Li-Xia. The examination went okay, and Li-Xia
did not have any trouble afterwards.

On Friday, November 10, 2006, Li-Xia went for a MRI scan. Afterward
she felt remarkable clear, but the effect did not last long.

On Thursday, December 7, 2006, we went to see the neurologist again.
She told us that all examinations point into the direction of
Alzheimer's Disease. She suggested that Li-Xia would start
with Reminyl.

Since December 2009, I have started brushing her
teeth. I also have taken over most of the home chores because
she started to make more and more errors. She still can do
some simple shoppings, not more than three kind of items
at the time. She has almost completely lost the ability
to write both with Chinese characters and Roman letters.
Personal hygiene is also becoming an issue.

Twice a week, on Thursdays and Fridays, Li-Xia attends a group of
young people with dementia at some nursing home.
There they also have some sports activities
and some memory training. (Some psychological exam has revealed
that in a sense her level of functioning is too low for this group.)
On all other weekdays she is visited by someone from
Rondom for additional
support.

Since the diagnosis, the condition of Li-Xia has slowly become
worse, as was to be expected. She mainly suffers from
apraxia in
the sense that she getting more and more problems with performing
daily routines. In July 2010, we have concluded that it is no
longer safe for Li-Xia to go biking on her home, and that her
impact on the family life is such, that it is better to have
her accepted in a nursing home. Becaues this cannot be realized
immediately, it was decided that she would go to some nursing home
four days per week and that during other times, people from Rondom
would visit our home to watch her.

In the second half of 2011, she started to speak Chinese predominantly,
occasingly using some Dutch words. She still seems to understand
Dutch. It seems she is no longer aware that she speaks multiple
languages and just uses the language that comes most natural to her.

She seems to be quite happy living in the nursing home, much happier
than a few years ago, when she was very much caught-up by trying
to perform all kinds of duties that she in fact was no longer
able to perform. She truly seems to enjoy life as it is.

During the summer of 2012, her condition progressed. She has started
to wander around more and more, losing contact with reality, suffering
from angry moods probably in combination with delusions. She has been
given some antipsychotic drug (in low dosage), which seems to help,
but maybe also contributes to her becoming more withdrawn. She can
no longer eat by herself and needs to be fed.
Stage 6 "Severe cognitive decline" in Seven Stages of Alzheimer's
now best fits her condition.

In the second half of 2012, she lost weigh with a rate of about 1.5 Kg
per month due to the combination of eating slowly and walking a lot.
Early 2013, verbal communication is
becoming more and more difficult, but she is happy and smiles a lot.
Non-verbal communication is still taking place and she looks more active
than in the months before.